Mask Mandates and the Rise of Faith-Based Policy
If something feels right, it really should be right, right?
Ahh the face mask. How can something so simple, cheap and disposable represent simultaneously the apparent last line of PPE saving us from viral-induced doom, as well as the symbolic harbinger of compliance to medical tyranny and the Trojan Horse of Communism? In the face of the heightened emotional propaganda that exists on both sides of this heated issue, it is worth stepping back and assessing what the evidence on masks actually says. Do they actually do anything? And if they do do something, is that thing good or bad? Then we can get to the second, more important question, which — for the time being — remains largely independent from the first: should we be wearing masks?
Before we start: a reminder, as you are probably already aware, that masks were not recommended as necessary in the initial stages of the pandemic. The official World Health Organisation (WHO) statement on masks at the end of January recommended those without respiratory symptoms to not wear masks, and even warned specifically that cloth masks “are not recommended under any circumstance”. What a difference a year makes, hey?
So, what are the relevant agencies currently using as their justification for imposing masks on people when they were previously thought unnecessary? Let’s start with the Centre for Disease Control (CDC) in the US, given it is probably the most influential agency (for better or worse) for Covid information in the world. Given anyone who questions the need for masks must prepare to be labelled a grandma-killer, one would expect its instructions for mask wearing for everyone over the age of 2 (?!) years old to be rigorously supported by science: perhaps a comprehensive bibliographical list of studies proving the link between mask wearing and reduced infections — perhaps also real time data from countries who have introduced mask mandates.
Yet, under the heading “Evidence for Effectiveness of Masks”, we have a grand total of 5 short paragraphs with reference to not a single peer reviewed academic study. Granted, we do get the cop-out “studies show” twice without any links to said studies provided (I’m not saying they don’t exist, I’m just saying this is lazy and invites cynicism). The paragraphs themselves are not even remotely scientific; their basic argument is: mask block respiratory droplets = mask good.
Ok, that was too much snark, too early. To be fair, the CDC does provide additional background information in a separate fact sheet (which I will get to later). However, the point still stands — because it is exactly the same rationale that they apply to their most recent recommendation of double masking. The recommendation, it appears, was based on a single study on mannequins that specifically warned its results were not applicable to real world settings (and that also warned that double masking can both impede breathing and obstruct peripheral vision).
Um guys: this isn’t how science works (it might be how Scientism works, but that is another story). The fact that a mask picks up some proportion of respiratory droplets from a person’s face does not by extension prove that masks are protecting people from a virus. This, if it was in fact proven, would still not prove that masks are actually having an overall net positive impact on public health, which one assumes would be the metric we are most concerned about. This is without even touching on the other issues: for example the psycho-social impacts, particularly for children, of normalising face coverings (and if you take a look at social media avatars you are well aware how fast this is becoming normalised), as well as the environmental impacts of such extreme levels of mask manufacturing and disposal.
This is, presumably, why the WHO were so equivocal about masks in the first place: it is only in our current times (let’s say AD, or after the first death, as opposed to the BC Before Covid times) where masks have been resurrected to take on their saviour-like status.
Now, what of Australia, where we have so far been spared the most evangelical aspects of the emerging mask religion. The Australian Government, to their credit, did attempt to provide a summary of selected research on cloth face masks (oops, don’t tell the WHO) in their relevant fact sheet from July last year. I say ‘selected’ deliberately, given they readily admit in the Conclusion that “time did not permit extensive review of this topic” — well that’s certainly reassuring, I’m sure they had more important things to do. The review mainly focuses on the largely undisputed claim that masks can stop respiratory particles, providing evidence for the fairly self-evident conclusion that face coverings of different composition will filter out varying proportions of airborne particles. I’m glad we can safely tick that one off.
(To deal with the snark, you might want to read this section while being thankful you have never had an Honours dissertation marked by me.)
There is one notable exception, however: a clinical study from Vietnam that compared the infection rates of three groups: no masks, cloth masks and medical masks. Not surprisingly, infection rates were significantly higher for the cloth mask group than the medical mask group. But this is the ‘best’ part: the rates of infection in the cloth mask group were also significantly higher than in the no-mask group. Where’s that face palm emoji…
As bold as it is to try and use this study as justification for the mandating of masks that will in practice be predominantly cloth, what else could they do if there was no science to suggest that basic-bish mask wearing translates to reduced infections or positive health outcomes? What they can do is put together a professional-ish looking (it’s certainly not InDesign level graphic skills) and on-face-value thorough literature review and assume that most people won’t actually take the time to dissect what the evidence really says (you are welcome).
The ultimate futility and desperation of their attempt is encapsulated in this gem of a passage:
“There are no randomised controlled studies of cloth masks in community or household settings. However, a recent report provides anecdotal evidence of cloth masks’ effectiveness for source control.”
We are then provided with an account of the exploits of two hair stylists from America, who apparently worked multiple days as asymptomatic carriers of Covid before they were subsequently diagnosed (reminder: if it was diagnosis by a PCR test, we can have little confidence that they really had Covid at all).
Imagine if I used this fluff as justification for trying to advocate for a health measure that doesn’t fit the preferred agenda of the narrative managers? “Actually, there is no real evidence that hydroxychloroquine (HCQ) is effective as a treatment against Covid-19. We are pretty sure it is though, and we have the testimony of two brick-layers from Perth, who were sick as dogs for 5 days before making miraculous recoveries after a few HCQ pills were jammed down their throats”. I would, rightfully, be mocked and sneered at: just like we still are now by many, even though we actually have science on our side.
But I’m not bitter, no not me. Perhaps I am being a bit harsh here: at least towards the actual researchers involved in pulling these summaries together, rather than the organisations they are employed for. I would strongly suggest that these poor keyboard warriors had been given the job of creating a document with the sole aim of supporting mask mandates, and cobbled together valiantly what they could. As someone who has worked on industry-funded research projects that are funded to specifically produce a desired outcome, I can relate.
It must also be noted that the situation has moved on since these resources were first released—we now have roughly 9 months of data to give us some sort of an idea on what masks may or may not be doing in AD times. As I mentioned above, the CDC does have a more recent scientific brief on mask wearing, which provides an overview of research from 2020 up to its publication in November of last year. It begins with our two favourite asymptomatic hair stylists: possibly not the most reassuring sign of the strength of the evidence that follows. Nonetheless, it does list several studies that are claimed to provide evidence for the effectiveness of masks in slowing the spread of Covid (might be worth including these as your ‘evidence’ on the main page then chaps?).
I get no particular joy from the fact that my trust in the CDC, and health bureaucracies in general (don’t get me started on our TGA, who are still strongly discouraging use of HCQ), is by this point non-existent, but hey: it is what it is. Thus: I have no doubt that this is a one-sided synthesis of the evidence written to meet a preordained objective we can all guess.
This is where things get tricky, because I’m not going to go through each study to check on whether it says what the CDC would like us to think it says (i’m already well over this particular dig). And this is presumably exactly what they want, because it is how they have gotten away with referring back to retracted and/or thoroughly discredited HCQ studies to claim it is neither safe or effective. I can refer you to this critique of the CDC review, which breaks down the issues with some of the studies included. The same website also has a list of graphs both in the US and other countries that suggest mask mandates have had little impact on Covid case numbers. But these kinda graphs really show nothing, are certainly not science, and seem to be cherry picked by both sides to try and prove their point.
So about here I hit a bit of brick wall. The public debate around this issue — as with virtually every major Covid-related issue — is confusing, disorientating, nasty, and in many ways incredibly toxic — especially on the main informational battleground that is Twitter. I’m pretty much done with it, and I fail to see how anyone approaching it from a neutral standpoint can make sense of the debate in its current predicament. If you have bias that you wish to be confirmed, there is more than enough for you to do so.
For example, I can point you to this review published in a peer reviewed journal. As an academic, it is an interesting paper, and about as close to expressing creativity as is possible for such a study — rather than the more typical and boring ‘systematic’ review, it offers ‘narrative’ review that creates its own framework in which to sort through the evidence surrounding masks. The article notes after its initial systematic review that “direct evidence of the efficacy of mask use is supportive, but inconclusive” — clearly not an acceptable outcome. It therefore brings in more creative modelling approaches to support its recommendation that “mask use requirements are implemented by governments, or, when governments do not, by organizations that provide public-facing services”.
But then, I can also point you to this counter review, which is highly critical of the current evidence base on masks and how it has been used to support policy-making. Importantly, unlike virtually every pro-mask analysis, it gives equal standing to research on the health risks of wearing masks. The review is not peer reviewed, it should be said, however the website it comes from (Swiss Policy Research) is run by a collection of academics (with no external funding) who publish articles challenging conventional media narratives on important policy issues. I am not saying they don’t have their own biases: just that their biases provide a necessary counter point to those that are forcibly projected onto us every day.
They are, of course, not the only people who have questioned the accepted narrative on face masks. This review does not deal with the most recent research (which is probably a good thing), but summarises the numerous studies from BC (i.e. before 2020) that have found no reduction in the incidence of respiratory disease through the use of face masks and respirators. The review goes further, and gives a good flogging to the generally accepted hypothesis that masks are actually doing us any good. If you want the full conspiracy takedown, you can watch this interview from two whistleblowers from the mask safety industry.
I’ll finish with this article from The Conversation, which is short, to the point and fairly neutral. It was also published mid 2020, before Covid kicked into full, second wave gear — and, hence, before the issue of masks became so politicised and propagandised — and is as a result refreshingly balanced and un-emotive. While advocating for the use of masks, it also points out the murkiness of the research, as well as discussing the numerous confounding variables that make this picture so murky. The entire dilemma of mask wearing is essentially summed up in this simple passage (which should be a single sentence, with proper punctuation, but I digress): “Multi-layered cloth masks are better at filtering but harder to breathe through. And they become wetter quicker than single-layer masks.” Really, it is that simple, isn’t it? In theory, you can create a mask that will essentially halt the spread of respiratory viral particles. However, doing so will increase the negative health impacts of the user, while also creating a more unhygienic vector for these particles to potentially spread from.
Someone should probably tell the double-mannequin-masking CDC. If they decide to move to three masks, at least we will know for sure that masks have jumped the shark.
So, what does it all mean Basil?
As with many things in life, we can gain clarity through the use of parks, this time in the form of an analogy. Just like the ability of masks to stop respiratory particles, it is an almost indisputable fact that being in a patch of idyllic urban nature is good for your health: physical, mental, spiritual, you name it. But this does not mean that mandating for parks to appear in every residential area will lead to overall improved health outcomes for that community. Firstly, we don’t know how many people will use the parks, which is determined by a range of complex individual and environmental factors. We don’t know the way people will use the parks while they are there. We also don’t know whether the parks are actually any good or not, and whether they may in fact be sites for health-decreasing behaviours. We don’t know if an over focus on parks might be counteracting other health promoting community resources.
This is why we need well-designed studies that investigate how these park requirements actually work in practice, which require understanding and consideration of all the different confounding variables that mediate the relationship between parks and overall population health. This is why, especially in the current politicised climate, it is probably still going to be some while before we are able to get a proper gauge on the impact that masks and mask mandates are having — that is, assuming that the level of disobedience to such mandates is not already at a level that will make any research essentially worthless.
So, just to be clear: I’m not saying that masks are ineffective as a health protection measure in a viral pandemic. What I would say, after diving in and eventually dragging myself out of the research and debate that surrounds it, is that Science doesn’t have the ability to conclusively decide either way — just like, regardless of what we are constantly told, and regardless of whether people want to hear this or not, science doesn’t have the potential to conclusively decide on any link between vaccines and various disabilities and diseases. Actually, while I am on a roll: just like we have no idea what, if any, health impacts technologies like 5G will have on humanity; we really are basing these things solely on faith — faith in science, faith in our own ingenuity (faith in our collective ego?).
Such doubt, to me at least, is unavoidable after the HCQ debacle revealed to me the level of corruption within scientific research and its communication to the public.
And it is through a comparison with HCQ (along with now Ivermectin) that the farce of mandating not just one but now two masks under the guise of evidence-based science comes into sharp relief. Because while there is really only theoretical potential for mask wearing to be saving lives, there is now almost conclusive, virtually undeniable evidence for these treatments that are saving lives in many places, yet are still not being used elsewhere.
I have written about this fact ad nauseam: see here and here for my most recent efforts. But this is the bottom line: there is no way to argue that the science on masks is settled, thus justifying mask mandates, while at the same time saying that more research is still required on HCQ and Ivermectin. And yet how many of the people telling us that we should have no choice to wear masks are also advocating for the systematic treatment of newly infected patients with successful HCQ and/or Ivermectin regimes? If you see one, please pass them on to me. This is why so many people, myself included, get what appears to be irrationally outraged about having to wear masks and being shamed in the process: the blatant double standards and hypocritical virus virtue signalling. My personal ‘favourite’ would be comparing mask deniers to people leaving their lights on during WWII bombings.
There is no doubt that it just ‘feels right’ that if we all put on masks it would help to slow the proverbial spread. It would certainly make the current situation easier to negotiate. Using our intuition is important, don’t get me wrong; it’s something we all need to implement in our personal lives. But something feeling right isn’t a basis for public policy making — this is a big distinction.
This is even more so the case with the absolute hilarity that is the CDC recommendation for double masking. For such controversial policy to be introduced basically on the assumption that face coverings partially stopping breath is equivalent to positive public health outcomes is such a profound leap in logic that it could be called a leap of faith. And that is what mask mandates ultimately are: faith-based policy making. Arguably the same faith that we place in vaccines that the unforeseen harms will not eventually outweigh their immediate benefits; or that we place in the rollout of new electro-magnetic technologies, whose oh-so-tempting extra convenience in our lives could not possibly have any serious side effects that we have not currently thought about.
In what situation would faith-based policy making be acceptable in a largely secular, rational society? When you turn the artefact in question into something resembling a religion.
Postscript
Now, with that snarky rant out of the way: the question of whether we should wear a mask or not is in many ways independent from this Scientism shamozzle. Such is the extent of the (let’s be honest here) propaganda that supports mask mandates, the majority of the population is convinced that mask wearing has far more proven benefit than it actually does. And that is a dilemma, if one wants to maintain compassion for those caught up in this brutal psychological operation. Regardless of how personally convinced anyone might be about the redundancy of covering one’s mouth with some type of miscellaneous fabric, to not do so when required makes you by default a ‘shit bloke’. Having to deal with that negative energy is exhausting, and is not for everyone. In the end, I would agree with this article that wearing a mask as an act of solidarity, to show that we are in this together, is by the far the most compelling reason to do so.
As a result, there is a bit of a split in the ‘truther’ community (where masks are almost universally considered useless face diapers) about how to deal with the mandates. Some have chosen this as their metaphoric hill to die on, and will simply refuse to comply — especially those who have valid health or psychological reasons for not wearing a mask. Others plan to compromise (read: fold like a cheap suit) under the pressure and comply to varying extents — the way I am headed. If you truly believe masks don’t work, then technically there is no wrong option (except probably to feel superior after choosing either option).
Speaking personally, I don’t want to normalise a world where people are forced to cover their faces, and am happy to err on this side, even if as a necessary counter to the prevailing mindset. If you think people in power wouldn’t try to normalise such a practice… well, there are obvious examples both in history and the world today which speak otherwise.
Even if do I end up having to mask up, which I will do if required, my message is staying the same: if you are going to have a strong opinion about masks and those who may choose not to wear them, you are obliged to at the same time be at least as outraged about the real life-saving treatments that are still being withheld. This would be my final advice, take it or leave it: for the sake of being on the wrong side of history, I would strongly advise against hero worship of those you think are keeping you safe, even while they continue to withhold these treatments from you and your at-risk loved ones.